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Cervical stenosis: Wait or treat?

Posted by mincer @mincer, Aug 25, 2021

Good evening to everyone, this last year has been a roller coaster I seen my neurosurgeon last week and discussed ACDF Surgery he has suggested to see him in five months as I don’t have the symptoms that relate to my MRI but do I wait until I fall in a heap or what are other peoples opinions attached a copy of my MRI

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ga29 | @ga29 | Apr 6, 2025
In reply to @upstatephil "@cjs4handgbear - Welcome to Mayo Clinic Connect. This is a great place to ask questions just..." + (show)
Profile picture for Phil, Alumni Mentor @upstatephil

@cjs4handgbear - Welcome to Mayo Clinic Connect. This is a great place to ask questions just like yours.

I had C4-7 (ACDF) 18 months ago. I was nearly 72 and in reasonable condition. I also had little direct pain so I never considered that an ACDF was on the table since I was really working to diagnose lower back pain which was much more painful and life-impactful. But, while digging to define my lumbar problems, the docs at Mayo took cervical images then showed me where the ACDF was necessary.

The good news is - The ACDF was fairly straightforward with a less than 24 hour hospital stay. I used very minor pain meds and I have felt fully recovered for some time. I'm only sharing this as - if an ACDF becomes the recommended treatment for you - that procedure and recovery can be quite tolerable.

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@upstatephil , I followed your comments regarding surgery on your neck and lumbar spine last year on this forum. Can you share who did your surgeries again?
I have done the required PT, and Ablations, epidurals. It’s time for some serious help.
My NS is apparently on leave, so I want to ask for another surgeon.
Thank you for your support.

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gramham | @gramham | Apr 6, 2025
In reply to @cjs4handgbear "85-year old male in reasonably good overall health - with the exception of recently diagnosed C4-5..." + (show)
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85-year old male in reasonably good overall health - with the exception of recently diagnosed C4-5 central canal stenosis with severe bilateral foraminal stenoses. This affects certain neck and, possibly, lower-back movements, especially while in bed. Surprisingly, I have very little pain when moving around during the daytime. Currently, I'm not considering surgery. Has anyone else with a similar condition, had Cortisone injections and, if so, what have been the results?

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I have been having pain in my right shoulder and down the arm. My pain doctor ordered a MRI which showed a pinched nerve betwene C8-T4. I had a epidural/steroid injection 3/31/25. I am almost a week into it. She said it would take a while for the steroid to take effect. The first day after I just took it easy, didn't see any difference, second day I had a really bad headache all day. I am almost 7 days and I my arm still hurts. I have to say that my whole spine is not in good shape. I have degenerative disc disease, have had lower spinal surgery 2X, Kyphoplasty 2X, several compression fractures that weren't caught in time to fix,(I now am humped) ostoporosis and arthritis. I am scheculed to see a neuro-surgeon 5/1. Let me add I am 88 years young and if it weren't for my spine I would be in pretty good shape. Someone younger without all the other things wrong, the injection would have a greater chance to work. Good luck on you decision.

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missey | @missey | Apr 7, 2025
In reply to @gramham "I have been having pain in my right shoulder and down the arm. My pain doctor..." + (show)
Profile picture for gramham @gramham

I have been having pain in my right shoulder and down the arm. My pain doctor ordered a MRI which showed a pinched nerve betwene C8-T4. I had a epidural/steroid injection 3/31/25. I am almost a week into it. She said it would take a while for the steroid to take effect. The first day after I just took it easy, didn't see any difference, second day I had a really bad headache all day. I am almost 7 days and I my arm still hurts. I have to say that my whole spine is not in good shape. I have degenerative disc disease, have had lower spinal surgery 2X, Kyphoplasty 2X, several compression fractures that weren't caught in time to fix,(I now am humped) ostoporosis and arthritis. I am scheculed to see a neuro-surgeon 5/1. Let me add I am 88 years young and if it weren't for my spine I would be in pretty good shape. Someone younger without all the other things wrong, the injection would have a greater chance to work. Good luck on you decision.

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I have an 86 year old friend who just had the treatment where cement type of material was placed into her spine to stabilize it because she was in so much pain. She said it was very helpful.

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gramham | @gramham | Apr 8, 2025
In reply to @missey "I have an 86 year old friend who just had the treatment where cement type of..." + (show)
Profile picture for missey @missey

I have an 86 year old friend who just had the treatment where cement type of material was placed into her spine to stabilize it because she was in so much pain. She said it was very helpful.

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I have had that procedure called Kyphoplasty done 2 times in the lumbar region. Also have had spinal surgery 2 times in same area.
My neck has a pinched nerve. I have pain medication that I do not like to take, but I did last night.

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gently | @gently | Apr 11, 2025
In reply to @gramham "I have been having pain in my right shoulder and down the arm. My pain doctor..." + (show)
Profile picture for gramham @gramham

I have been having pain in my right shoulder and down the arm. My pain doctor ordered a MRI which showed a pinched nerve betwene C8-T4. I had a epidural/steroid injection 3/31/25. I am almost a week into it. She said it would take a while for the steroid to take effect. The first day after I just took it easy, didn't see any difference, second day I had a really bad headache all day. I am almost 7 days and I my arm still hurts. I have to say that my whole spine is not in good shape. I have degenerative disc disease, have had lower spinal surgery 2X, Kyphoplasty 2X, several compression fractures that weren't caught in time to fix,(I now am humped) ostoporosis and arthritis. I am scheculed to see a neuro-surgeon 5/1. Let me add I am 88 years young and if it weren't for my spine I would be in pretty good shape. Someone younger without all the other things wrong, the injection would have a greater chance to work. Good luck on you decision.

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gramham, so each segment of the spine would have a different area of nerve compression. While the nerve could be pinched at each level, a single epidural wouldn't cover the distance. You didn't even get temporary relief from the epidural which indicates that they missed the pain source.
I'm a little afraid of epidurals, but I did have relief from a brachial branch block with pain resembling yours from an orthopedic surgeon. I hope you have a good experience with your neuro-surgeon on May 1. Let us know.

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